Background. In recent years the treatment of primary nocturnal enuresis (PNE) with desmopressin (DDAVP) has been promising. The route of administration until now had been intranasal, but because the tablets were introduced for the treatment of diabetes insipidus they have also become available for the treatment of PNE.Objectives. To find the optimal dosage of desmopressin tablets and to compare desmopressin's efficacy with placebo in a group of adolescents with severe monosymptomatic enuresis. The long-term safety of desmopressin was also studied in the same group of patients.Methods. The effect of oral desmopressin (1-deamino-8-D-arginine-vasopressin) (DDAVP? tablets, Minirin?) was investigated in 25 adolescents (ages 11 to 21 years) with severe monosymptomatic nocturnal enuresis. The first part of the dose-ranging study comprised a single-blind dose titration period, followed by a double-blind, crossover efficacy period comparing desmopressin with placebo. The final part was an open long-term study consisting of two 12-week treatment periods. The efficacy of the drug was measured in reductions of the number of wet nights per week.Results. During the first dose-titration period, the majority of the patients were given desmopressin 400 μg, and the number of wet nights decreased from a mean of 4.9 to 2.8. During the double-blind period, a significant reduction of wet nights was observed (1.8 vs 4.1 for placebo). During the two long-term periods, 48% and 53% of the patients could be classified as responders (0 to 1 wet night per week) and 22% and 23.5% as intermediate responders (2 to 3 wet nights per week). No weight gain was observed due to water retention. After cessation of the drug, 44% of the patients had a significant decrease in the number of wet nights.Conclusions. Oral desmopressin has a clinically significant effect on patients with PNE, and therapy is safe when administered as long-term treatment.
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机译：背景。近年来，用去氨加压素（DDAVP）治疗原发性夜间遗尿症（PNE）很有希望。迄今为止的给药途径是鼻内给药，但由于该片剂是用于治疗尿崩症的药物，因此它们也可用于治疗PNE。为了找到去氨加压素片的最佳剂量，并比较去氨加压素与安慰剂在一组严重单症状性遗尿症青少年中的疗效。在同一组患者中还研究了去氨加压素的长期安全性。口服去氨加压素（1-deamino-8-D-精氨酸-血管加压素）（DDAVP？片，Minirin？）在25例严重单症状性夜间遗尿症青少年中进行了研究。剂量范围研究的第一部分包括单盲剂量滴定期，然后是对去氨加压素和安慰剂进行比较的双盲，交叉功效期。最后一部分是一项开放的长期研究，其中包括两个12周的治疗期。通过减少每周湿夜的次数来测量药物的功效。在第一个剂量滴定期间，大多数患者接受了400μg的去氨加压素治疗，湿夜次数从平均4.9降至2.8。在双盲期间，湿夜明显减少（安慰剂为1.8 vs 4.1）。在这两个长期期间，可以将48％和53％的患者归为有反应者（每周0至1个湿夜），将22％和23.5％的患者归为中度反应者（每周2至3个湿夜）。由于保水，未观察到重量增加。停止使用该药物后，有44％的患者的湿夜次数明显减少。口服去氨加压素对PNE患者具有临床上显着的疗效，长期使用该疗法是安全的。
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